Motivation by Carrie Saulters

As the end of the year or season comes around what keeps you motivated to keep coming back every year? It is easy to point out that almost every athletic trainer puts in a lot of hours and can easily feel “burnt out”, but what makes it all worth it?

 I recently had this conversation with another athletic trainer and we decided that what helps us the most is remembering why we picked the field of athletic training in the first place and holding on to the feelings of those you have helped.

Everyone has a different reason for choosing the field of athletic training. I have heard stories from others about being injured while they were in high school, college or they just had a passion for helping people and loving sports. An athletic trainer somewhere made a difference in their lives.  Try to think of that when you are winding down at the end of a season. The athlete you are treating still deserves your very best and you may ignite a passion for the field of athletic training in them, like you once felt.

We also decided that reflecting on the thank you phone calls or emails from students or parents can help ease the burden of working so many hours at the end of the season or year. We also discussed that not everyone has a positive work environment, so it may be up to you to set that tone. Show your co-workers that you have enthusiasm for your job and your athletes and you will set a positive example.

                                                                            

Emotional Resilience by Michelle Holt

In a recent survey that I came across, emotional resilience was defined as is the ability to positively adjust to an adverse, stressful, or difficult situations and maintain one’s good mental health.  The goal of this survey was to understand emotional resilience of athletic trainers and the factors that may contribute to emotional resiliency in different workplace settings. This is really important for each individual to question, and I believe handling confrontation is a one of those factors.

One of my personal strengths (Gallup’s Strengths Finder 2.0 by Tom Rath) is harmony. I LOVE when people put aside differences to harmonize or at least cooperate in life and work, making the positive results that much greater. I used to steer clear of confrontation thinking that it hurts harmony, and I confused it as creating conflict rather than finding a solution to the problem. Before I was mature enough to learn, I struggled in a work environment that was full of it, crumbling emotionally instead of rising to my potential. I also experienced a work environment that was the other side of the spectrum where confrontation was avoided so much in the culture that there was a huge lack of accountability. In this situation, accountability would be necessary for making progress. So, it was ton of effort to make the wheels spin but we were still going nowhere. After different stages of learning the hard way, I see and accept confrontation as an opportunity to build harmony and as a leadership skill that is vital to hold your team together through accountability.

I bring this topic up because I think that in any job the right fit for someone has a lot more to do with this aspect of emotional resilience. Think about emotional resilience as it relates to how you interact with others, but also how the environment (mainly the people) allow you to maintain a healthy mental state. People around you have different skill levels and methods keeping the emotional balance. What do you need and what do you need to do to positively impact your work and life environment?

ATs hosting secondary school PPE’s

It’s that time of year again for secondary school ATs. The medical eligibility paperwork process for next year is in full swing. Since we just wrapped up hosting our own physical exam night, I have PPE’s on my mind. All the hard work and preparation my worker and I did in advance kept things going as smoothly as it could have gone…even despite the doctors showing up late or cancelling last minute. But, when it was all said and done I couldn’t help but question, why do all this?

We had a simple but specific process in place to have our high school and middle school students sign up for our physical exams. We had been planning, communicating with coaches and pushing out the broadcast in many different ways for weeks leading up to our event. Still, the final result of numbers was more than disappointing. We had such a small percentage of our student athletes that needed physicals actually take advantage of what we offered.

We do this for a few benefits, primarily being cheap and convenient for busy parents and athletes. The goal of hosting PPE’s is to help complete a significant portion of our population’s medical paperwork requirements in a timely manner. It is also a benefit to have our high quality physicians helping. Then we as athletic trainers are immediately aware of the “red flag” positive medical findings and are able to address the next steps with the parents in a timely manner.

After all our efforts of communication, we still didn’t have the back-up we needed from the coaches to get the kids/parents to sign up. For many, following instructions to complete the sign-up was a struggle. Regardless of how many actually come, we put the same amount of time and effort into the details of orchestrating and setting up the event. The nicest way to sum up our event was a BIG hassle with very little outcome. On top of it all there are now many local clinics that offer “cheap and easy” sports physical exams with extended night and weekend hours available. Parents often jump to these options anyways. So, it brings me to ask, was it really worth it? Do we do this again next year?

Consistent with the recommendations of the NATA’s Safe Sports School Award (link below, check it out!!), I feel athletic trainers are responsible to coordinate PPE’s. However, we do this as we communicate to parents how to fulfill the PPE requirements and as we diligently collect the paperwork to ensure that each athlete has completed this and has the necessary medical information on file. From my perspective this does not mean that we are not adequately doing our jobs if we do not host a physical exam event at our school. If you’re a secondary school AT have you had similar struggle hosting PPE’s? Do you feel pressure to provide physicals at your school?

http://www.nata.org/sites/default/files/SafeSportSchoolAwardPacket.pdf

District VI memories

Recently, SWATA announced the election results, and welcomed Chris Hall as the new district director.  We also saw Valerie Hairston named to her second term as the Member-At-Large, and Lorna Strong as the Eddie Wojeki recipient.  What an awesome group of candidates and award winners!

I had the pleasure of working as a student under Chris Hall at TCU.  He has such a passion for the profession, and his love for the work we do truly shows.  Texas and Arkansas have been able to do so many things on both the state and local level, and I look forward to everything that we will do in the future. 

As we creep towards the July meeting, I wanted to take some time to reflect on all the work Kathy Dieringer has done as the District VI director.  During the 2014 convention, Kathy asked the Young Professionals’ Committee to tackle the NPI contest.  The YP’s teamed up with the PR, CUATC, and COPA committees to increase both awareness and on-site NPI registrations.  As committee chair, I was thankful for Kathy reaching out and trusting me with this initiative.  I know there are many stories out there just like mine- District VI what are some of your memories of working alongside Kathy? 

Current Events by Kimber Rodgers

There have been a lot of legislative initiatives recently.  Many of which will affect athletic trainers.  There are some others that will also affect teachers in the public schools.  If you are a secondary school athletic trainer, like me, you could possibly be affected by all of these.

This has definitely opened my eyes to several things!  I will admit, in the past, when I receive an e-blast from NATA or SWATA I usually read the subject line then delete it.  After becoming more involved and becoming a member of the Young Professionals’ Committee, I have made a conscious effort to read all of the communication I receive.  I never realized what I had been missing out on!  There is so much information conveyed in those e-blasts!

Recently, a friend of mine got a new job, and when discussing salary with his employers, they used the NATA salary survey “like it was the Bible.”  However, a majority of athletic trainers licensed and certified did not participate in the survey.  How will we get an accurate picture of the profession as a whole if we, the members, are not willing to provide our input?

Job Strategies for the Young Professional: A Brief Interview with Chris Young. By: Kimber Rodgers

Recently, I spoke with Chris Young, a colleague and classmate from graduate school.  He has had several unique job experiences so far in his athletic training career; working as an intern for the Oakland Raiders and the  Phillies organization, with US Soccer, an assistant and head athletic trainer at a NCAA Division I university, and in a clinical setting as an outreach coordinator.  So I asked how he has gotten to where he is and what advice he might offer to other young professionals.  Here is what he had to say:

Me: What has made you able to obtain the positions you’ve had?
Chris:  A lot of it was that I was in the right place at the right time. There were a lot of times where I just worked hard and did some of the grunt work and put in my time doing the not so fun stuff.  I didn’t really realize that people were paying attention.  I didn’t think I was doing anything special; I was just doing what they taught us in school.  But, people were paying attention and thought I was doing a good job.  So it was partially “right-place-right-time”, but I feel like I worked hard to prove that I was good enough.  A lot of it is just work ethic.

Me: Do you think that the people that you have met while in those different positions have helped you?
Chris:   The big thing that [our professor] taught us is to never burn a bridge.  So, I’ve tried really, really hard.  You know, there’s times where you have to bite your tongue.  There’s times when your day just sucks but you just have to grin and bear it and do what you’ve got to do to hold up your end of the deal.  For me, fortunately, it worked out to where it turned into some things that were bigger and better than where I was at before.

Me:  So do you think it was the other athletic trainers you’ve met that have helped you, or the coaches you’ve worked with?  Who do you think has really helped you along the way?
Chris:  I think it’s been a good sampling of everything.  I really attribute a lot to the connections I’ve
made.  You know, the athletic training world is really small.  Just trying to stay connected with people; because, as you move on and leave a place, that’s just another connection.  I think the people I’ve worked with or worked for, I was just fortunate to be with, even if it was just a short time in that setting.  So, you just work hard and stay connected to them.  Then, when there’s something you want to do, you reach out to them and say, “Hey, I don’t know if you know anybody but…” and if you do enough job they’ll stick their neck out for you.

Me: What are some things that you’ve learned that were not so good, that may have been disadvantages of the different settings you’ve been and what have you learned from that?
Chris:  One of the worst relationships I’ve had with an administrator is when I just wasn’t respected.  I was young and probably had no business having that job and they knew it, so they told me about it.  I had a really hard time with that.  I may have been a little more vocal than I should have been, but there are definitely some things I could have done differently.

Me:  So, did that experience change and shape how you did things in your next position?
Chris: Something I didn’t do that I should have done, and I will make sure to do going forward, is the very first thing to do when I get to a new setting is I’ll sit down with the coach or athletic director and say, “What are your expectations of me?”  Then we’ll have a conversation of what it is they expect from me.  And I’ll tell them what I expect on the athletic training side.  Communication and respect are big things.  If I had done that, it probably would’ve changed things.  Communication is so important! And you have no idea who is watching.

Me:  What advice would you give to young professionals, that are just starting to look for jobs, or those who are looking to work in a new setting?  What advice would you give them that is maybe something you wish you would have known right out of school?
Chris:  I started an internship position, hoping that they may have a full-time position at the end of the summer.  But they didn’t, so I was scrambling to find something.  But all I found was another internship.  I remember calling home at one point and I was so frustrated and said, “I am always going to be the professional intern! This is not why I went to grad school.” And my dad said, go ahead and stick it out and see how it goes.  That eventually turned in to my US Soccer job, which basically gave me the foundation to do anything I want to do.  Because I stuck it out; it was that grunt work and the stuff that nobody wants to do.  Sometimes you’re the low man on the totem pole.  You just have to be a little bit humble.  I wish I would have paid a little bit better attention to the people I was around.  Like at Tech, or when I was with some of the pro-teams - you’re just wide-eyed and trying to take everything in. You’re going to get into a setting where you just have to do it; and the more you’ve seen and the more you’ve been around, the more you can make good decisions on “yeah, I saw that, great!” or “yeah, I saw that, but I’d do it a little bit different.”  People ask me now, “What did you do with the Raiders?” “I don’t know!  I was just a little intern and was so excited to be there.” And I didn’t pay as close attention as I should have.  Just try to soak everything up that you can.

Athletic Training: A World of Adventure by Mark Stephens

I love being an athletic trainer!  Why?  One word: adventure.  This career, certainly in the traditional setting, is never dull, never the same, always changing.  Every season brings new athletes, a few new coaches, new opponents, new game strategies and new injuries.  No injury is the same because the athletes are different.  This alone keeps you thinking, keeps you fresh.

In my short time of being an athletic trainer, I have gotten to experience traveling, TONS of games, hundreds of athletes and hundreds of coaches.  I have worked with injured 12 year old athletes who are as young as 12 years old, and others who are close to 30.  I have provided athletic training services to at least 17 different sports from beginning levels to collegiate championship levels and beyond.  Each of these sports and teams remain in the memory banks for highs of winning, lows of losing, difficulties conquered and goals reached.  Each event is an adventure.

As I age, it becomes too easy to dwell on the negative and fail to see the adventure and enjoyment that surrounds our profession every day.  I can recall going to AT conferences and listening to the older ATs complain about playoffs and long seasons and long days, working with athletes, parents, coaches, etc.  I made a resolution to do everything I could not to become “that guy”, that sour man who hates life.  One of the ways that I have found that combats that sour disposition from sinking in is to cherish the adventure within the profession.  To be honest though, I still sometimes find myself sinking into that sour outlook, but when I focus on the adventure and true enjoyment of what we do, I find the sourness fades.

There are many adventures that athletic training has taken me on.  It’s been ride, some of highs and some lows. However, it may be your biggest adventure you take in life. And, I can tell you from first-hand experience, if you are not careful and pay attention, it will go by in a blink. Cherish the memories you’ve made and work to make new ones you are to remember in the future. 

Communication: The Key Component in Athletic Training by Mark Stephens

What is the one word that we think of when we hear the word communicate?  Talk. Well, sometimes it may not be so simple.  You often have trouble finding the right words.  Talk to whom exactly?! Talk to your friends, your parents…your colleagues?  And, tell them what?!  It’s hard enough to talk to those who are close to us like our family and friends but what do we do when we have a superior?   We must be open and honest.  Regardless if what we have to say is good or bad, more of than not the truth overrides falsehoods. 

Do you ever remember your parent’s tell you “As long as you tell us the truth, you won’t get in trouble”.  I know what you’re thinking. “Uh huh, sure”. Well in this case it’s the truth.   As health care professionals in the career of athletic training, communication is the key component to establishing a successful and effective working relationship with your superior.  If you think about it, what is the one thing that we are asked as by the coach and athletic staff when we witness an injury?  “Is he /she okay”? or “how bad is it”…” do you know when they will be back to full status”.    When this happens, we get a little nervous and become apprehensive on what to say.  It’s during this time when I remember that as long as I speak the truth, I will not get into trouble.  I’m sure we can all agree that we if we are honest and up front with our coaches and athletic staff about an injured athlete, we do them a service.  Often at times we think we may hurt the coaches feelings and make them upset by not telling them what they want to hear. However, I defy anyone to tell me otherwise. 

Manual Therapy in the Secondary Setting- Friend or Foe? By Cat Webb

Personally I have been using manual therapies in my secondary setting for a couple of years now. At first I was hesitant in my career and soon realized the benefit they had to offer. My top 3 go to manual therapies are: Positional Release Technique (PRT), Muscle Energy Technique (MET) and Mulligan manual therapies with mobilizations. Each of these techniques did require additional certifications and education. Nevertheless, as an athletic trainer in the secondary setting I am improving my overall treatment time by reducing my clinical treatments from an average of 5 days (5 treatments) to 2 days (2 treatments). I am also able to perform all of these manual therapy treatments on the field and return patients to play pain free immediately.

I have had great success using PRT with headache patients including concussion patients, neck pain/soreness and low back pain/soreness.  Positional release technique (PRT) is a unique method that has been gaining popularity as a manual therapy technique with lasting effects by decreasing muscle tension, fascial tension and hypomobility, in turn increases range of motion (ROM) and decreases pain.¹   PRT is a method that uses a total body screening evaluation to locate tender points (TP) while placing the patient in a position of comfort (POC) to resolve dysfunctional tender points.  This indirect technique involves positioning the patient away from resistance and towards the direction of greatest ease, opposite that of stretching.   Theory behind PRT,  is that by placing the compromised tissues into a position of  relaxation for a period of time you will decrease gamma gain and facilitate restoration of normal tissue length and tension.^1,3,4  The application of PRT by the clinician relaxes the muscle-spindle mechanism and breaks down the contraction,³  allowing the clinician to provide biofeedback while palpating the TP and breaking the chain of muscle contraction that causes pain or weakness from the point of dysfunction. 

On the other hand, I have had great success treating patients with MET that complain of pain or soreness along the following muscles-sartorius, rectus femoris, iliopsoas and quadratus lumborum.  MET is a direct mobilization technique that uses voluntary contraction by the patient to treat soft tissue restrictions.¹ MET was developed based on the principles of proprioceptive neuromuscular facilitation (PNF).  MET has been found to normalize joint ROM,² increase joint mobility, increase flexibility,³ strengthen muscles and relax hypertonic shortened muscles.  Exact theories are unclear as to why MET works, one theory suggest that MET releases restricted joints through isometric muscle action known as autogenic inhibition.⁴  This theory addresses treating postural and phasic fibers through MET.  In order to isolate both fibers the patient contraction must occur between 10 and 30 percent.  This allows for avoidance of fatigue which can occur during a more vigorous contraction, such as in PNF.  The second theory addresses only the postural muscles, also known as non-fatiguing muscles.  This type of contraction occurs with less than 30 percent to avoid the stretch reflex.  MET works during this type of muscle contraction by resetting the gamma gain of the muscle spindle and possibly creating a voluntary contraction of the opposite muscle. Muscle energy techniques can be applied in two different methods based upon the patient’s pain.  Patient’s reporting with tightness should be treated with a post isometric relaxation technique where the agonist muscle is being isolated.  This isolation increases the neurofeedback through the spinal cord during the isometric contraction.  This in turn causes re-education in the muscle tone.  This is very similar to PNF with relaxation after an isometric contraction however performed with less intensity.  If the patient reports pain then the clinician would choose the method of reciprocal inhibition muscle energy techniques.  Reciprocal inhibition treats the antagonist and is used for acute injuries that are painful.  This allows the clinician to treat in mid-range instead of end-range and avoid pain by treating opposite of the injured muscle.²

Mulligan Mobilization with movement (MWM) is a system of manual therapy interventions developed by Brian Mulligan that I have had great success treating lateral ankle sprains, tennis/golf elbow, loss of supination/pronation, loss of interphalangeal joint movement and tight hamstrings.  This manual therapy combines a sustained manual ‘gliding’ force to a joint with concurrent physiologic (osteokinematic) motion of the joint, either actively performed by the patient, or passively performed by the operator. The manual force, or mobilization, is theoretically intended to cause repositioning of ‘bony positional fault’. The intent of MWMs is to restore pain-free motion at joints which have painful limitation of range of movement (ROM). Therein lies one of the key aspects of the mobilizations with movement system: a trial of MWM at the time of the initial patient examination will determine whether MWM is an appropriate therapeutic intervention for that patient’s dysfunction. If a trial of MWM is able to eliminate the pain associated with an active movement, then MWM is an appropriate intervention; if not, then MWM is not an appropriate intervention. In the event that a trial of MWM is not able to eliminate the pain associated with an active movement, the therapist should not employ the MWM, and other therapeutic interventions should, therefore, be explored.

All in all, manual therapies are your friend. They reduce your patient load by decreasing your overall treatment time and accurately treating the patient’s pain instead of using a band-aid. I hope they become your friend as they are mine and you begin the research process of finding the best ones that fit your practice. Hopefully the 3 listed above are a good starting point.

Calling all young professionals to NATA!

The Young Professional’s Committee has some new and exciting tricks up their sleeve for this year’s convention in Saint Louis. 

For starters, be on the lookout for registration information about our career session that will be held on Wednesday afternoon.  We will be blasting out an announcement in the next issue of NATA News and ROM.  Our session will feature mock interviews where YP’s can be both the interviewer and interviewee.  Want to touch up those skills prior to a big interview this summer?  This is the session for you!  Want to start working on your skills so you can help with the interview process for that new assistant position at your job?  This session has something for you as well!

The Young Professionals and Cramer will be teaming up once again to host the YP lounge event.  Be on the look out for the announcement in the programming guide.  Last year’s lounge event in Indianapolis was so successful- we had almost 500 people present!  Come out and enjoy meeting the hall of fame members, the YP committee members, and many others within the profession.  Grab a drink with your free ticket, and rub elbows with the professions’ finest.

Lastly, do not forget to look for the YP stamp on the programming guide.  This stamp indicates the sessions that are geared towards the young professional.  Go check them out!

See you in St. Louis!

Where's The Money by Julie Ellena

As most of you may of seen in the January edition of the NATA news, a new Athletic Trainer Salary survey has been released. As a profession our salaries have increased steadily since 2011. The national average for full time position in 2014  was $55,036. In District 6 the average salary  reported was $64,126 which is six thousand dollars above and beyond the previously reported salary. Across the nation salaries increased, the largest increase in salary over the last 3 years was the young professional group (1-5) years of experience, improving more than 12 percent.

As the profession moves forward with this knowledge, we are look forward to continue success showing our value. With the current healthcare model in America the athletic trainer is receiving increased value. Our skill set is unlike any other, various health care professionals and community health organizations are stating to take notice. Our efforts are being helped by medical issues occurring in the spotlight (concussions, heat illness and unfortunately, the death of athletes)  and being talked more and more in the mainstream media. We are seeing parents, realize what an assets an athletic trainer is and parents are taking action to save AT jobs and create new ones.

As our profession continues to change and grow with the nation's health care needs, we expect the salaries will continue to increase as more and more individuals are taking a proactive approach to healthcare, rather than a reactive one. Let continue to improve and show our value, it's working.

For more information on the salary survey, there is a free interactive salary database www.nata.org/nata-salary-survey.

On the Cutting Edge of Everything, by Julie Ellena

As Athletic Trainers we are expected to on the cutting edge of health care, as individuals we are expected to be in the know about new trends and technology, but at what point does one decided they can not be on the cutting edge of everything. There will always be the new rehabilitation exercise or routine, a new tape technique, the latest phone update, injury tracking program, etc. So how do we decided what to filter in and what to filter out in the flow of information we process daily. One of the best athletic training resources I have found to keep me informed is an email called "Athletic Trainer Weekly" Its a weekly email that collects articles from around the web that relates to the athletic training profession. It's a great addition to the emails I receive from the NATA Blast and NATA Monthly (both which are great benefits of NATA Membership!) According to the Athletic Trainer Weekly website (http://athletictrainerweekly.com) "Athletic Trainer Weekly is a free, weekly curation of the best information for athletic trainers from the web and from experts in the field."  Personally, I enjoy reading the Athletic Trainer Weekly. It is organized and published by a fellow Athletic Trainer and it's divided up by subject matter: In the News, For the Kit, From the Field, Hit the Books, Sage Advice, Up the Ladder, and they typically have a funny story or video at the end.  Go Check it out! It's free and not many things in life are free. Happy Reading!

Advocating to Secondary School Administration by Michelle Vryhof Holt

No matter what situation we are in or where we are working at we should be advocates for ourselves, each other and our profession. I have recognized that even our biggest allies in our workplace can still benefit from conversation and understanding of what it is we really are able to do and what we should be responsible for. It is vital to clarify realistic expectations with those that we must answer to in order to preserve that providing quality medical care to student-athletes or patients is the most important thing we do and must be made priority over all else.

I have been very fortunate to be in company with those who exemplify this. I currently get to witness and assists behind the scenes with the process of proposing another full-time athletic trainer for each school in our district to the chain of command in administration. It is a great experience for a young professional growing in my career and equips me for the tools to effectively move a motion like this one forward myself if the future presents the opportunity. I want to share some tips I have learned to others who may find themselves alone in such a position.

1)      Education is always the first crucial step in order to see actions made in our favor. School or district administration professionals will not understand the need to act if they don’t understand how important our role is and how well we fulfill the needs they might not even realize they have by doing what we are skilled and trained to do as medical professionals.

2)      Plan a way to present that keeps them engaged, perhaps a powerpoint could help. Try to say what you need to say in as few words as possible and keep the information organized so it flows.

3)      Numbers talk. Try including a graph or chart to document points that can help support the need. Ideas may be injury rates in seasons, season overlaps including “off-seasons” that still compete, coaching staff growth rates vs. support staff growth, and change in athlete/athletic trainer ratio over time.

4)      What are the most important athletic trainer’s responsibilities related to care and what are the “other duties as assigned” that could take away from that quality of care?

5)      If you bring up the amount of hours you work, try to frame it in a different light. Others work long, long hours too but how could it affect someone’s life? It may help to focus on fatigue’s potential effect on skills and judgment in critical injury situations, especially at the big events at with high injury potential at the end of the week.

6)      Stay positive! It can be easy to list out the complaints. If the tone can somehow stay positive with energy focusing on the goal of helping the student athletes, there is a much better chance that your important information doesn’t fall on deaf ears.

7)      Be prepared with alternative ideas that could still benefit you and rebuttals to potential questions. Is it appropriate for a head coach or coordinator be your direct supervisor? Maybe an open line of direct contact to administration is a key that helps the seed spread.

8)      Don’t let the conversation stall. It will take time to pass through the levels for consideration, so keep stimulating the topic with your admin. Also, try to plan for proposal at the beginning of administration’s budget planning process so that timing works in your favor.

9)      Most importantly, don’t give up! Keep trying different ways to help those above you understand, and when personnel changes occur realize the opportunity for a recharge in your advocacy efforts.